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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 3/2018

Open Access 01-12-2018 | Review

Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy

Authors: Walter P. Weber, MD, Martin Haug, Christian Kurzeder, Vesna Bjelic-Radisic, Rupert Koller, Roland Reitsamer, Florian Fitzal, Jorge Biazus, Fabricio Brenelli, Cicero Urban, Régis Resende Paulinelli, Jens-Uwe Blohmer, Jörg Heil, Jürgen Hoffmann, Zoltan Matrai, Giuseppe Catanuto, Viviana Galimberti, Oreste Gentilini, Mitchel Barry, MD, Tal Hadar, Tanir M. Allweis, Oded Olsha, Maria João Cardoso, Pedro F. Gouveia, Isabel T. Rubio, Jana de Boniface, Tor Svensjö, Susanne Bucher, Peter Dubsky, Jian Farhadi, Mathias K. Fehr, Ilario Fulco, Ursula Ganz-Blättler, Andreas Günthert, Yves Harder, Nik Hauser, Elisabeth A. Kappos, Michael Knauer, Julia Landin, Robert Mechera, Francesco Meani, Giacomo Montagna, Mathilde Ritter, Ramon Saccilotto, Fabienne D. Schwab, Daniel Steffens, Christoph Tausch, Jasmin Zeindler, Savas D. Soysal, Visnu Lohsiriwat, Tibor Kovacs, Anne Tansley, Lynda Wyld, Laszlo Romics, Mahmoud El-Tamer, Andrea L. Pusic, Virgilio Sacchini, Michael Gnant

Published in: Breast Cancer Research and Treatment | Issue 3/2018

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Abstract

Purpose

Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion.

Methods

The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology.

Results

Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference.

Conclusions

In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques.
Appendix
Available only for authorised users
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Metadata
Title
Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy
Authors
Walter P. Weber, MD
Martin Haug
Christian Kurzeder
Vesna Bjelic-Radisic
Rupert Koller
Roland Reitsamer
Florian Fitzal
Jorge Biazus
Fabricio Brenelli
Cicero Urban
Régis Resende Paulinelli
Jens-Uwe Blohmer
Jörg Heil
Jürgen Hoffmann
Zoltan Matrai
Giuseppe Catanuto
Viviana Galimberti
Oreste Gentilini
Mitchel Barry, MD
Tal Hadar
Tanir M. Allweis
Oded Olsha
Maria João Cardoso
Pedro F. Gouveia
Isabel T. Rubio
Jana de Boniface
Tor Svensjö
Susanne Bucher
Peter Dubsky
Jian Farhadi
Mathias K. Fehr
Ilario Fulco
Ursula Ganz-Blättler
Andreas Günthert
Yves Harder
Nik Hauser
Elisabeth A. Kappos
Michael Knauer
Julia Landin
Robert Mechera
Francesco Meani
Giacomo Montagna
Mathilde Ritter
Ramon Saccilotto
Fabienne D. Schwab
Daniel Steffens
Christoph Tausch
Jasmin Zeindler
Savas D. Soysal
Visnu Lohsiriwat
Tibor Kovacs
Anne Tansley
Lynda Wyld
Laszlo Romics
Mahmoud El-Tamer
Andrea L. Pusic
Virgilio Sacchini
Michael Gnant
Publication date
01-12-2018
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 3/2018
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-018-4937-1

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